California over-drugs — and fails — foster children: Editorial

"I felt like I was a prisoner in my own body," said Rochelle Trochtenberg, 31, a former Los Angeles foster youth who now lives in Eureka, Calif. Here, Trochtenberg fixes her hair as she spends time with her dogs in the backyard of her Eureka home on May 14, 2014. Trochtenberg now holds down a full-time county job, travels up and down the state speaking out on youth mental health issues, and is working on a master's degree. But she often wonders whether the years she spent in foster care on numerous psychotropic medications caused her lasting harm. It's embarrassing when she brings a cup to her mouth and people ask why her hands are shaking so violently. "I don't want to tell people I have a tremor because I was drugged for my whole adolescence," she said. (Dai Sugano/Bay Area News Group)

Will Lightbourne, head of California’s Department of Social Services, says there’s no simple way to end the pattern of thousands of foster children spending much of their youth drugged into malleability.

That’s the horror revealed by reporter Karen de Sá on Sunday’s Page One.

Lightbourne says it has to be part of the holistic rethinking of the entire foster care system that’s underway, giving doctors better options than prescribing psychotropic drug upon psychotropic drug to control children who act out.

Really? Really? If this isn’t a crisis, then what is?

The abusive use of powerful medications on kids with formative brains cries out for action. Each child who grows up scarred by this is a human tragedy and, in many cases, a lifetime burden on society.

Yes, the whole foster care system needs rebuilding, and yes, that could reduce the incentive to drug kids to alter behavior. But we can’t write off the children in the system now. That’s like declining to treat a cancer because the cure hasn’t been found.

It’s time to act. There are things the state can do now to at least begin to control the damage to children’s minds and physical health.

Foster children are the most vulnerable of California’s young. They are in state custody as a last resort because going back to their families is impossible. Thousands of them are given powerful psychotropic medications — often two or four or more at a time, prescribed to deal with behavior and not to treat the mental illnesses for which the FDA has approved them. They can lead to lifetime health problems, such as obesity.

De Sá relates story after story of young people who experienced overmedicating in foster care. One, Rochelle Trochtenberg, as a teenager was diagnosed, so to speak, with a laundry list of mental illnesses, including bipolar and post-traumatic stress disorders. When she turned 18 and left the system to live on the streets — don’t get us started on that aspect of foster care — she was on 10 medications. When she finally got real help, she came off drugs entirely and now is working on a master’s degree.

Advertisement

Anecdotes do not prove a problem; the data does that. But it’s important to look at individuals’ stories to understand why waiting for global solutions to the foster care system is not tenable.

De Sá found 12.2 percent of California foster children who received a psychiatric drug last year were taking several drugs at the same time. System insiders say it’s often in doses never determined to be safe for children, whose brains are still developing. How is this even legal? And how hard can it be to limit?

There are simple rules that could help. As just one example, California appears to have cut the use of antipsychotic drugs in children under 5 a few years ago when it added an additional layer of documentation required of doctors. The Department of Health Care Services is looking at requiring the same for teenagers. Why not immediately?

Three years ago the federal government identified overuse of psychotropics on foster children as a national problem and ordered states to come up with plans to control it. The committee California set up has moved at a snail’s pace, unable to get access to prescribing information, among other issues. Members are frustrated. They don’t expect to finish their work until at least 2016.

Frustration is no surprise. It took our sister news group nine months to get the data for these articles, and it’s required by law to be public as long as identities are concealed.

Lightbourne might be able to pull off a holistic remake of the foster care system. We hope he does. But massive drugging of California’s foster children is not a problem that can wait. The state needs to act now.